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Dorothy K. Grange, M.D.

• Division of Genetics and Genomic Medicine
• Department of Pediatrics
• Washington University School of Medicine
• St. Louis, Missouri

The report outlined horrific sexual abuse against women xanax muscle relaxant qualities carbamazepine 400mg line, including oral spasms brain carbamazepine 100 mg overnight delivery, anal muscle relaxant lodine generic carbamazepine 100mg on line, and vaginal rape spasms sphincter of oddi buy generic carbamazepine line, by male correctional staff, who used physical force, threats, privileges, gifts and their positions of authority to coerce and abuse women. Two years later, Human Rights Watch (1998) issued a follow-up report which outlined significant physical and sexual abuse and retaliation against women prisoners in the Michigan Department of Corrections. In 1998, the United Nations sent a special rapporteur, Radhika Coomaraswamy to investigate these allegations of sexual misconduct in womens prisons. Publishing her report in January 1999, Coomaraswamy (1999) found widespread abuses in many U. Amnesty International (1999) joined the debate with its report, Not Part of My Sentence: Violations of the Human Rights of Women in Custody," and found that Many women inmates are subjected to sexual abuse by prison officials, including: sexually offensive language, observation by male officers while showering and dressing, groping during daily pat-down searches, and rape. There are substantive differences between the ethos of male prisons (marked by violence, degradation and predatory behavior) and those of female prisons, where women engaged in non-sexual friendships and play (pseudo) families which had been earlier described by Giallombardo (1966) and Ward and Kassenbaum (1964, 1965). Three (3) behaviors in particular where found to cause problems for female prisoners in the mix described as any behavior that can bring trouble and conflict with staff and other prisoners (Owen, 1998: p. Women involved in these negative activities also engaged in exploitative relationships, both economically and emotionally; the women prisoners interviewed by Owen recommended avoidance of these behaviors to avoid conflict. Bennett conducted face-to-face interviews with 101 inmates residing in a therapeutic community within a mediumsecurity Delaware prison. The sample was largely African-American (92%), with 5% White and 3% Hispanic prisoners, whose average number of incarcerations was 3. In total, one (1) inmate reported completed rape in his lifetime of incarceration, and five (5) inmates reported attempted rape, two (2) of which had occurred within the last year. In general, the inmates interviewed, contrary to their direct experiences, estimated much higher rates of sexual victimization: 15. Nonetheless, this research called into question the actual incidence of the problem. This was to change significantly, however, with another study of Nebraska prison facilities. This was also one of the first systematic studies of prisoner sexual violence in female institutions. In total, there were 516 usable inmate surveys returned (30% return rate), and of a total staff of 714 in the four prison settings, there were 264 staff surveys returned. Of prisoner respondents, 104 inmates (20%) of the total number of respondents 101 (22%) of the male prisoners and 3 (7%) of the female prisoners had been pressured or forced to have sexual contact (touching of genitals, oral, anal or vaginal sex) against their will while incarcerated, with more than one-quarter (29%) of the incidents qualifying as gang rapes (two or more offenders). Alarmingly, 4% of the respondents reported having been the victim of sexual assault between fifty-one and 100 times. These results were confirmed by the separate survey of 714 correctional staff, including correctional officers, unit mangers, administrators and treatment staff, whose reported incidence varied by facility type. For those targeted for sexual victimization, 75% reported at least one force tactic. Additionally, in a manner different that their male 113 counterparts, the female prisoners estimated that the actual rate of coerced sex was lower (3%) than the actual rate reported (7%). For those respondents who were targets of sexual assault, they reported an average of nine (9) incidents. Unexpectedly, staff were reported to be sexual perpetrators in 18% of the incidents reported. The majority of targeted inmates experienced profound negative reactions, including depression and 36% suicidal ideation (36%). More importantly, this study raised the alarm as to how serious and prevalent prisoner sexual violence was in correctional settings, and set the stage for continued examination. Increased attention on the issue of prisoner sexual assault caused a number of correctional agencies to take note and respond. In the Commonwealth of Massachusetts, the first state-level hearings on prisoner rape took place in May 1994 in response to a series of articles which appeared about rape in Massachusetts prisons which appeared in the Boston Globe (Senott, 1994). As a result, the Massachusetts Department of Correction developed a sexual assault prevention curriculum for correctional staff, both for pre-service and in-service training (Dumond, 1994), and initiated a pro-active intervention policy for inmate rape (Massachusetts Department of Correction, 1995). The Twenty-First Century: the Dawn of a New Era: At the turn of the century, concern about prisoner sexual violence continued to be raised in a number of venues, and led to considerable expansion of knowledge about the problem. This sample was substantially larger than their earlier study (Struckman-Johnson et al. Of these, 131 (7%) incidents of rape (oral/genital) used force tactics and 67 (40%) of the rape incidents occurred between 1996-1998. Both inmates and staff generally agreed on level of protection at each facility larger mens prisons were given low rating of protection. Again, this new study revealed continuing incidence of staff sexual misconduct 20% of the inmates from larger prisons stated a male or female staff had participated in the worst-case sexual coercion act. Interestingly, when inmates were asked to identify how frequent they thought sexual assaults were occurring, they had a tendency to overestimate the amount of sexual coercion than was actually recorded. The high sexual coercion rates found in these correctional institutions were specifically correlated with five (5) factors: 1) use of barracks housing, 2) racial conflicts, 3) lax security, 4) prison inmate population over 1,000 and 5) larger inmate population with crimes against persons. The team proffered that the presence of a sufficient number of motivated security staff and tight security measures appeared to limit sexual coercion among inmates and also noted that a facility that used lockdown procedures had a zero rape level (Struckman-Johnson & Struckman-Johnson, 2000: p. Alarid conducted an innovative examination of a womans correctional facility through three different methods: initial surveys of women in a large Southern urban jail, followed by follow-up information from a random group of 25 women who responded to the initial survey, and content analysis of weekly prison letters sent by one women offender over a period of five years, as she transferred to four or five different female units at this facility. The letter writer, Velmarine, was a 41 year old African American mother of three children, serving a 25-year prison term for a third felony conviction who acknowledged being in the mix and vividly described both her own experience of sexual coercion and rape and those of other women in this facility. The results of this study provide intriguing insight into womens correctional facilities. Four (4) main themes emerged: (a) apathy toward sexual coercion and sexual assault, (b) the jailhouse turnout femme as the sexual aggressor, (c) insight into one rape 115 situation and (d) institutional factors contributing to sexual assault (Alarid, 2000: p. In general, sexual harassment and pressuring occurred more often than sexual assaults, which often went unreported to correctional authorities. In particular, Velmarines insights are crucial: If it were not for the fact that most female inmates capitulate with coercion, there would be more forced sex act or threats of violence, thereby causing recognizable rapes to be a more common occurrence among women prisoners (Alarid, 2000: p. Women prisoners who engaged in homosexual relations were most vulnerable to sexual aggression, particularly those women who adopted the masculine role of stud. In general, while rape occurred less often in female prisons, when it did, women were likely to be victimized by multiple perpetrators. Correctional staff need to focus on identifying and curbing sexual coercion, to preempt more aggressive incidents, and need consistent training to understand the dynamics of female sexual coercion, and to hold women accountable for sexual infractions. Alarid (2000) also suggests the use of cameras in vulnerable areas, such as restriction dorms, and inmate orientation to new prisoners, advising them of how to avoid becoming a target, and what assistance is available (legal, medical, psychological) if they are targeted. Dumond (2000) noted with alarm that staff sexual misconduct is often ignored in corrections, and he continued to advocate for comprehensive staff training, strong administrative policies and procedures, and sound treatment interventions for victims of sexual assault to meet individual needs and to ensure institutional safety and security. Nearly all of the officers (96%) reported that it was sometimes difficult to tell whether inmates were being forced to participate in sexual acts or if they were willing partners in consensual sexual activities (Eigenberg, 2000a: p.

In playgrounds designed to serve children of all ages spasms kidney area discount 200mg carbamazepine amex, the layout of pathways and the landscaping of the playground should show the distinct areas for the different age groups muscle relaxant 563 purchase carbamazepine 200 mg with amex. Signs posted in the playground area can be used to give some guidance to adults as to the age appropriateness of equipment muscle relaxant 1 order discount carbamazepine online. Appropriate surfaces are either loose fill (engineered wood fiber kidney spasms causes buy carbamazepine 100mg with amex, sand, pea gravel, or shredded tires) or unitary surfaces (rubber tiles, rubber mats, and poured in place rubber). Research has shown that equipment heights can double the probability of a child getting injured. We recommend that the height of equipment for pre-school age children be no higher than 6 feet and the height of equipment for school age children be limited to 8 feet. Head entrapment occurs when the body fits through a space but the childs head cannot pass through the same space. If the space between two parts (usually guardrails) is more than three and a half inches then it must be greater than nine inches to avoid potential entrapment. A rung missing from a ladder, which is the major access point onto a piece of equipment, poses an unnecessary injury hazard for the child. This weakens the equipment and will eventually create a serious playground hazard. Wood structures must be treated on a regular basis to avoid weather related problems such as splinters. Plastic equipment may crack or develop holes due to temperature extremes and/or vandalism. To Parents: Submission of this form to the child care provider implies consent for the child care provider to discuss the childs health with the childs clinician. A helmet pushed up too high will not 1 protect the face or head well in a fall or crash. Mouth 3 buckle and chin, but it should be tight enough that if your child opens their mouth, you can feel the helmet pull down on top. Choose one that your child before playing at the playground or climbing likes and will wear. If standards were merged from multiple 2nd Edition standards, the merged 2nd Edition numbers are listed in the 2nd Edition column. Appendix Title G G Recommended Childhood Immunization Schedule H New Recommended Adult Immunization Schedule I H Recommendations for Preventive Pediatric Health Care J I Selecting an Appropriate Sanitizer or Disinfectant K 3. Paul Division of Public Health, Minnesota Department of Health, infections in infants and children in situations associated with an Washington County Public Health, and Bloomington Division of increased risk of serious infection with a specifc disease. The antisiphon ballcock does not allow dirty water to metabolite occurs in soil, decaying vegetation, hay, and grains unbe admixed with clean water. Pesticides: Regutypes of beverage containers, compact disks, plastic dinnerware, lating pesticides. Achieving and measuring experienced, they typically consist of fever, swollen glands, and success: A national agenda for children with special health care fatigue. The decibel level is the number of decibels of noise problem early, to understand a disease problem better, and to perceived or measured in a given place. Dental sealants are usually applied after a child individuals know what to do in particular disaster situations and reaches the age of six when the frst permanent molars come in. Chronic creas produces insulin, but the body cannot use it, often because of obstructive pulmonary disease. Medline Plus Medical Dictwelve children, including the caregiver/teachers own children. See also Child specifcation for impact attenuation of surfacing materials within care health consultant. See also held by covered entities and gives patients an array of rights with Child:staff ratio. Hib should not be confused with the fu which skin and mucous membrane infections; the most common infection is a disease caused by a virus. In the most severe infections, the virus diseases in child care and schools: A quick reference guide. It provides temporary ach fu, which is usually an infection caused by a different type of protection against diseases such as hepatitis A. Vaccines may contain an inactivated or killed agent or a to eliminating the root causes of pest problems, providing safe and weakened live organism. The federal funding is allocated to therapeutic, and health needs, and to deal with the familys needs individual states in accordance with the Individuals with Disabilities to the extent to which the family wishes assistance. Meningitis is usually caused by a bacterial or can cause a pregnant woman to miscarry.

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The pest control professional can use this document to ensure that a thorough inspection has been completed spasms perineum trusted carbamazepine 200 mg. The pest control professional muscle relaxant used in surgery quality 200 mg carbamazepine, however spasms rectal area order 100 mg carbamazepine amex, should not limit the inspection solely to what is indicated on the checklist spasms gerd order discount carbamazepine on line. Following this review, the Principal will report on the effectiveness of the plan to the local school board, and the plan may be revised as needed. It is often very difficult and laborious to eliminate most ants from their outside habitat, so management efforts should aim at preventing ants from invading structures. Unfortunately, prevention is not always successful and management actions must be implemented. By aerating soil and recycling dead animal and vegetable material, they aid in the formation of topsoil. Ants provide a great service to the environment, and management efforts that prevent or suppress ants are preferred over practices that aim to eliminate ants. They live in colonies whose members are divided into three castes, workers, queens, and males. The workers enlarge and repair the nest, forage for food, care for the young and the queen, and defend the colony. After a short period of time, adult ants emerge from their pupae cases and become worker ants. The first step in managing pest ants is proper identification, since many types of ants may invade a structure. It is critical to identify the type of ant you want to manage, because most ants differ in their habits and food preferences. Damage Many species of ants, such as pavement ants, are particularly prone to infesting food. However, ants walk over many different kinds of surfaces and sometimes feed on dead animals and insects, so it is possible that they can carry disease-causing organisms to human food. Assume that ant-infested food has been exposed to organisms that can cause spoilage, and throw it away. Carpenter ants may cause some structural damage as they excavate moist, rotting wood and other soft materials (such as foam insulation board) to make satellite nests. Along with a pest control professional you will likely also need a carpenter and or a plumber to correct the problem. Carpenter ants may mean a leaky roof or pipes, repair any water leaks and replace moist or rotting wood as needed. A thorough inspection and prevention program is required to locate the ant source. Ants are most likely to be indoor pests in kitchens and food preparation areas. Make a map of the school on which you can note problem areas and areas needing repair. Carry a caulking gun to seal holes and cracks during inspection to prevent ants from gaining entry to the structure. An ant infestation may indicate that there has been a change in the methods of storing food or food waste that allows increased food sources for ants. Note how food and food wastes are stored in the area, and whether refuse containers are emptied and cleaned regularly. Inspect recycling bins to ensure that recyclable items have been cleaned before being placed in bins. Talk with kitchen staff and custodians to learn more about the problem from their perspective. Ants can be attracted to snacks kept in classrooms or teachers lounges and to sweet drinks accidentally spilled on the floor. Glue boards or sticky traps placed in areas ants are likely to be found can be useful in monitoring. Check any areas where there might be a water leak, or moist or rotting wood (including firewood, logs, sick looking trees or tree stumps outside the building). Management Options Habitat Modification the environment should be modified to reduce ant entryways and access to food. With quality materials and careful work, the alteration will be permanent and will make a long-term impact on the number of ant invasions. It is not necessary or practical to seal all cracks, but begin with the access point that the current trail of ants is using. Always carry caulk when making inspections, and seal as many cracks as time allows, especially those around baseboards, cupboards, pipes, sinks, toilets, and electrical outlets. Thorough daily cleaning of school kitchens and food preparation areas is essential. If children regularly receive snacks in classrooms, these floors should be vacuumed and/or mopped daily. Periodically give all food preparation areas a complete cleaning, focusing on areas where grease and food debris accumulate. These include drains, vents, deep fat fryers, ovens, stoves, and hard-to-reach areas behind or between appliances. Use soapy water to wash any bottles, cans, wrappings, and other items that have food residues before storing them for recycling. If dishes cannot be washed right away, it is very important that they at least be rinsed to remove all food debris. Place garbage in sealed plastic bags, then place the bags into a rodent-proof dumpster or other storage receptacle. Keep garbage cans and dumpsters as clean as possible to deny food to ants, as well as roaches, flies, mice, and rats. Anyplace a trail of ants has been seen should be cleaned with soap/detergent and water to remove ant pheromone trails (a scent trail left for other ants to follow). Proper Food Storage Food not kept in the refrigerator should be kept in containers that close tightly. Although refrigerator storage is usually safe, ants sometimes get into refrigerators even when the seals appear intact. When this occurs, a light, temporary coating of petroleum jelly on the edge of the refrigerator seal will exclude the ants. Screw-top jars are ant-proof only if the lid has a rubber seal, because some ants can follow the spiral ridges to get into the jar. Glass containers with rubber gaskets or plastic containers with tight-fitting, snap-top lids are also ant-proof. To prevent roach problems, do not bring shipping boxes into the food preparation area. Instead, boxes should be broken down and stored away from the kitchen in a cool area until removed for recycling. Storage shelves should be far enough off the floor to facilitate cleaning and to reduce the possibility of access by insects or rodents. They produce secretions that impart a characteristic fetid odor, and their shed skin contains allergens that may cause allergic reactions such as asthma and other bronchial problems in people inhabiting or visiting infested buildings. Identification and Biology Except for size and markings, cockroaches are generally similar in appearance: all species are flattened, oval-shaped insects with long legs and antennae. In general, cockroaches like to squeeze into warm cracks and crevices, but the places they inhabit differ from one species to another. German cockroaches prefer kitchens and lavatory areas, while brown-banded cockroaches are most often found in dryer classroom and office areas. American and oriental cockroaches are generally found where there is high moisture, such as in sewers, basements, and mulch. In German cockroaches, the female transports the egg case around with her until the eggs are about to hatch. The brownbanded, American, and oriental cockroaches deposit the egg case in a sheltered place. An immature cockroach, or nymph, looks much like an adult, but is smaller and wingless. They will discriminate among foods if given a choice, but when hungry they eat almost anything. Some products not normally considered food, starch-based paints, wallpaper paste, envelope glue, and bar soaps contain carbohydrates, and therefore are food for cockroaches. Daylight sightings usually indicate a large population that has overrun available harborage or a recent emigrant cockroach seeking shelter.

Deep venous thrombosis in children with musculoskeletal infections: the clinical evidence muscle relaxant intravenous buy carbamazepine pills in toronto. Deep venous thrombosis associated with acute hematogenous osteomyelitis in children muscle relaxant pictures buy genuine carbamazepine. Diagnosis and treatment of pediatric chronic osteomyelitis in developing countries: prospective study of 96 patients treated in Kenya spasms in spanish generic carbamazepine 100mg otc. Recurrent osteomyelitis caused by infection with different bacterial strains without obvious source of reinfection spasms 1983 download 400 mg carbamazepine overnight delivery. The role of Panton-Valentine leukocidin in Staphylococcus aureus musculoskeletal infections in children. Prospective survey of acute osteoarticular infections in a French paediatric orthopedic surgery unit. Epidemiology of 377 paediatric osteoarticular infections and evaluation of management protocol. Pediatric osteoarticular infections caused by Streptococcus pneumoniae before and after the introduction of the heptavalent pneumococcal conjugate vaccine. Kingella kingae sequence type-complex 14 arthritis in a 16-month-old child in Greece. Clinical features and microbiology in 204 cases of septic arthritis in Malawian children. Pharmacokinetics and pharmacodynamics of oral cephalexin in children with osteoarticular infections. By supporting innovative health care projects, policy-oriented field research, and public education, we serve as an advocate and catalyst for change in national and international policies and programs. This report was written by Adrienne Germain, Vice President of the International Womens Health Coalition, and is based on papers commissioned for and presentations made at the conference Reproductive Tract Infections in Women in the Third World: National and International Policy Implications. Brief quotations may be reproduced without written permission, on the condition the report and publisher are cited and reference is made to the conference. We are therefore urging family planning and health Some 80,000 mothers developed programs to undertake initiatives to postpartum pelvic infection. In 1991, we co-sponsored, cerned about the behavioral and with the Rockefeller Foundation, the socioeconomic dimensions. A deeper international conference reported on and expanded understanding of the here. The book, Reproductive male-female relationships, and of the Tract Infections: Global Impact and universalities, as well as the differences, Priorities for Womens Reproductive in sexual behavior is essential. Embree, Sexually Transmitted Diseases: Current and Future Dimensions of the Problem in the Third World, in Adrienne Germain, King Holmes, Peter Piot, and Judith Wasserheit, eds. Many existing in the reproductive tract; reasons have been postulated: sex is and 1 Women [in Kenya]. Ngugi, University of Nairobi Women in the general population are considered to be at low risk because they Kenya do not have high rates of partner change and large numbers of partners. The striking exception is chlamydia, for which median prevalences are nearly identical. Luthra against further behavioral and gender Southern populations means that large and Badri N. Saxena role research, and against education for portions of the population are in the Indian Council of young people and children, are widely sexually active ages; population growth Medical Research and deeply held. Schulz, Joanne Schulte, and Stuart Berman, Maternal Health and Child Survival: Opportunities to Protect Both Women and Children from the Adverse Consequences of Reproductive costs. Given competition Nancy Pielemeier ative to those of other health activities for limited or shrinking resources, the U. Additional data will be tional agency commitment to create beyond this selected group useful to identify and implement more broader social conditions in which of participants.